The global fight against tuberculosis is gaining some powerful tools. Precision medicine — already used to personalize diagnosis and treatment of noncommunicable diseases such as cancer — and health care technologies such as telemedicine have the potential to advance the prevention and treatment of tuberculosis, says Zelalem Temesgen, M.D., an infectious diseases expert and medical director of the Mayo Clinic Center for Tuberculosis. Mayo's Center for Tuberculosis is a World Health Organization collaborating center on digital health and precision medicine for tuberculosis. The center partners with institutions around the world to improve the quality of care for tuberculosis patients. Areas of focus include using e-learning tools to share the latest medical knowledge with health care providers and exploring how genomics and other precision medicine capabilities, artificial intelligence that supports clinic decision-making, and mobile ways to connect with patients, such as video visits and texting, could be harnessed and spread around the globe. "Too many people still suffer from this disease," Dr. Temesgen says. "Even though the United States is a low TB-burden country, our elimination goals have not been met and much remains to be done to accelerate our progress. Additionally, we must continue to support other countries and regions where infection rates are much higher." Roughly 25 percent of people worldwide are infected with the airborne bacterium that causes tuberculosis, and tuberculosis is among the top 10 causes of death in low- and middle-income countries, according to WHO. The disease usually attacks the lungs, but may also affect the brain, spine, and kidneys. The Mayo Clinic Center for Tuberculosis' work includes establishing continuing medical education in tuberculosis, HIV, and associated conditions; the program includes consultations on complex cases and technical assistance to participating institutions. The program has a multidisciplinary, multinational faculty and working relationships with organizations in Latin America, the Caribbean, Africa, India, and England. The COVID-19 pandemic has disrupted tuberculosis prevention and treatment internationally, threatening to roll back progress made fighting the disease, Dr. Temesgen says. Tuberculosis is curable with prompt diagnosis and treatment, but if not treated properly, can be deadly. "COVID-19 also has highlighted, perhaps as has never been done before, the importance of public health," Dr. Temesgen says. Last year, the center collaborated in a COVID-19 "datathon," an intense workshop modeled after computer programming marathons called "hackathons," and plans to hold one on tuberculosis this year. In a datathon, researchers work in teams to frame a research question, mobilize data to search for the answer and present their findings to a panel of judges. "Ideally, a datathon is an intellectual testing pit full of the data and constructive criticism it might take months to sort out otherwise," Dr. Temesgen says. The pandemic's acceleration of telemedicine to connect patients to health care providers remotely has also heightened the center's interest in convening colleagues to evaluate the status of virtual care for tuberculosis and to identify research gaps and other needs that must be addressed to speed its use, Dr. Temesgen says. — Agencies
